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Femoral pain after hip prosthesis

Seung-Yup Lee, Hong-Chul Lim, Ki-Mo Jang, Ji-Hoon Bae
BACKGROUND: When using the gap-balancing technique for TKA, excessive medial release and varus proximal tibial resection can be associated with internal rotation of the femoral component. Previous studies have evaluated the causes of femoral component rotational alignment with a separate factor analysis using unadjusted statistical methods, which might result in treatment effects being attributed to confounding variables. QUESTIONS/PURPOSES: (1) What pre- and intraoperative factors are associated with internal rotation of the femoral component in TKA using the gap balancing technique? (2) To what degree does femoral component rotation as defined by the navigation system differ from rotation as measured by postoperative CT? METHODS: Three hundred seventy-seven knees that underwent computer-assisted primary TKA attributable to degenerative osteoarthritis with varus or mild valgus alignment in which medial soft tissue release was performed, and those with preoperative radiographs including preoperative CT between October 2007 and June 2014 were included in the study...
March 23, 2017: Clinical Orthopaedics and related Research
Mark R Adams, Conor Dunn, Michael S Sirkin, Mark C Reilly
INTRODUCTION: Long-term bisphosphonate therapy for osteoporosis is associated with an increased risk of low-to-no energy atypical subtrochanteric and femoral shaft fractures with characteristic radiologic findings. There are few reports of patients with long-term bisphosphonate-induced periprosthetic fractures, all of them had a hip arthroplasty prosthesis. In this report, we present a unique case of a 90-year-old Caucasian female on long-term bisphosphonate therapy with a sliding hip screw implant who sustained a periprosthetic fracture of the femoral shaft at the distal aspect of the plate...
September 2016: Journal of Orthopaedic Case Reports
Gurava Reddy Ay, Soundar Rajan D, Chiranjeevi T, Karthik C, Krishna Kiran E
INTRODUCTION: Disengagement of polyethylene insert used in total knee arthroplasty is a rare but serious complication. Still rarer is disengagement because of failure of tibial insert locking mechanism. We report a previously unpublished complication of polyethylene insert locking mechanism failure in a 10-months-old posterior stabilized total knee arthroplasty in a 70-year-old woman with osteoarthritis for whom Attune (Depuy) knee implant was used. CASE PRESENTATION: A 70-year-old female underwent (Attune, Depuy) primary bilateral posterior stabilised total knee arthroplasty in a private hospital...
July 2016: Journal of Orthopaedic Case Reports
Jason Bt Lim, Chia Liang Ang, Hee Nee Pang
INTRODUCTION: Bipolar hemi-arthroplasty of the hip is a commonly performed procedure in elderly patients with intra-capsular fracture of the neck of the femur with good short-term results for pain relief, return to activity and morbidity. The incidence of intra-pelvic prosthesis migration or protrusion is rare and one of the inciting factors is chronic low-grade sepsis. Acetabular prosthesis protrusion poses a difficult and challenging surgical problem due to surrounding neurovascular structures...
July 2016: Journal of Orthopaedic Case Reports
Xavier Lizano-Díez, Eduard Alentorn-Geli, Alfonso León-García, Fernando Marqués-López
A fracture of the stem in a total hip arthroplasty (THA) is an uncommon complication. We report a case of femoral stem fracture in a 55-year-old male patient after a lightning strike. A revision was conducted using a Wagner osteotomy and a revision prosthesis. Dall-Milles cerclages were used to close the osteotomy. The postoperative evolution was satisfactory, with an immediate partial weight bearing, consolidation of the osteotomy after three months and return to daily activity without pain.
January 2017: Acta Orthopaedica et Traumatologica Turcica
S K Suwal, P Songming, L Gang, H Kui
INTRODUCTION: Fused or Ankylosed hip is late complication of chronic inflammatory disorder with progressive changes in and around articular as well as periarticular structures with alteration in bio-force line of body which later lead to severe flexion deformity of joint. This not only results decreased movements of hip, it's also increase pain around the hip, back and contralateral hip. METHODS: Retrospectively, all patients aged 18 years or older undergoing THA between June 2006 to June 2012 were reviewed with selection criteria...
April 2016: JNMA; Journal of the Nepal Medical Association
A Sánchez, R Blanco
The aim of the study is to report the rare association of two complications of long-term treatment of osteoporosis with bisphosphonates in the same Caucasian elderly patient. A female patient of Italian descent, age 87 years, consulted in February 2013. She had a history of osteoporosis and had taken alendronate weekly for 7 years (1999-2006). Due to low back pain, an orthopedist had indicated i.v. zoledronic acid, 5 mg/year for 3 years (2006-2008). She received occasional supplements of ergocalciferol...
March 2017: Osteoporosis International
Shao-Chuan Huo, Fan Wang, Lu-Jue Dong, Wei Wei, Jing-Qi Zeng, Hong-Xing Huang, Qing-Min Han, Rui-Qi Duan
BACKGROUND: Short-stem (SS) prostheses require less resection of the femoral neck, produce a more physiological load pattern in the proximal femur, reduce stress shielding, and aid bone conservation and are, therefore, beneficial for young patients. Conventional cementless implants in total hip arthroplasty (THA) have shown excellent clinical results; however, it is unclear whether SS prostheses can obtain the same clinical and radiological outcomes. We conducted a meta-analysis of randomized controlled trials (RCTs) to evaluate whether SS prostheses are superior to conventional implants after primary THA...
October 2016: Medicine (Baltimore)
C Morin, C Ursu, C Delecourt
INTRODUCTION: The everyday life of a non-ambulatory adolescent or young adult with cerebral palsy can be severely impaired by a painful or stiff hip. The usual surgical solutions such as proximal femoral resection (PFR) are not entirely satisfactory for pain relief, and are mutilating. HYPOTHESIS: A retrospective study assessed the impact of total hip replacement (THR) on such impairment, on the hypothesis that it is more effective than PFR in relieving pain, without aggravating disability...
September 30, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
X Flores, M Vicente, S Haddad, C Amat, L Carrera, P S Corona
BACKGROUND: Bone loss in the distal femur is a common problem in knee revision surgeries. The problem is exacerbated in the context of an active infection. In extreme cases this bone loss could compromise the feasibility of a two-stage exchange protocol using dynamic spacers due to the inherent instability of this type of spacers. Use of a hip prefabricated spacer in a "reverse" way forming a ball-and- socket joint is a therapeutic option in cases of massive bone defect and infection...
November 2016: Revista Española de Cirugía Ortopédica y Traumatología
David Clinton McNabb, Jason M Jennings, Douglas A Dennis
INTRODUCTION: Physiologic strain patterns of the femur are altered by the bending stiffness of the implant as well as the loading pattern of the implant itself. The Savish Range of Motion (S-ROM) femoral stem has been designed with flutes (to decrease distal material) and with a coronal slot (to decrease stiffness). MATERIALS: The purpose of this case report is to briefly discuss design characteristics of femoral stems and their relationship to thigh pain as well as to describe the only report in the literature of a fracture of the anterior spline of a S-ROM prosthesis at the coronal slot...
July 25, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Xin Tang, Jing Zhu, Zongke Zhou, Bin Shen, Pengde Kang, Fuxing Pei, Jian Li
BACKGROUND: The treatment of elderly patients with Kashin-Beck disease (KBD) remains clinically challenging, and clinical data are very lacking. The aim of this study was to retrospectively evaluate pain and functional outcomes following total hip replacement in adult patients with severe KBD of the hip. METHODS: Twenty-two patients (32 hips) with KBD underwent primary hip replacement and were followed for at least 2 years. Radiographic and Clinical assessments were evaluated for each patient at 2 and 4 weeks and at 3, 6 and 12 months after the operation and annually thereafter...
2016: BMC Musculoskeletal Disorders
Güray Toğral, Şefik M Arıkan, Timur Ekiz, Ahmet F Kekeç, Mehmet F Ekşioğlu
Although challenges in treatment of musculoskeletal hydatid cysts (HC) lesions have been documented, data regarding the musculoskeletal HC lesions resembling tumor is scarce. This paper presented 5 patients (3 males, 2 females) with a mean age of 41.6 years with tumor-like lesions of HC. Three of them had left ilium and acetabulum involvement, one involved left femur, and one involved left thigh muscle compartments. Pain was the main symptom and was seen in all patients. Clinical examination, radiologic evaluation, and histologic analysis were performed for diagnosis...
May 2016: Orthopaedic Surgery
Bradford S Waddell, Ivan De Martino, Thomas Sculco, Peter Sculco
BACKGROUND: Total hip arthroplasty is a successful operation for the treatment of hip pain. One of the common complications of hip arthroplasty is dislocation. While reduction of standard prosthetic dislocations is highly successful, new prostheses add the potential for new complications. CASE REPORT: We present the case of a patient who experienced intraprosthetic dislocation of an anatomic dual-mobility total hip prosthesis after a closed hip reduction and include the prereduction and postreduction radiographic findings...
2016: Ochsner Journal
Olav Reikerås
PURPOSE: Femoral component revision with either cemented or proximally coated stems has been disappointing, but revision with extensively coated stems has been promising. Our purpose was to evaluate the long-term outcome using an extensively hydroxyapatite (HA)-coated stem in femoral revisions surgery. METHODS: During 1988-1993 we performed 66 femoral revisions in 65 patients (49 women), mean age 58 (range, 28-86) years. We used a grit-blasted straight stem made of TiAl6V4 designed for press-fit insertion (Landos Corail; Landanger, Chaumont, France)...
February 2017: International Orthopaedics
Ning Xu, Junying Sun, Xijiang Zhao, Tao Wang
OBJECTIVE: To investigate the application and effectiveness of the biological type acetabular cup(diameter < 44 mm) in adult Crowe type IV developmental dysplasia of the hip (DDH). METHODS: Between April 2001 andAugust 2013, biological type acetabular cup was used in total hip arthroplasty for the treatment of Crowe type IV DDH in16 cases (20 hips). There were 3 males and 13 females, aged 31-69 years (mean, 49 years). Unilateral hip was involved in 12cases, and bilateral hips in 4 cases...
January 2016: Chinese Journal of Reparative and Reconstructive Surgery
Denis Nam, Toby Barrack, Staci R Johnson, Ryan M Nunley, Robert L Barrack
BACKGROUND: Patient-perceived noise from prostheses after total hip arthroplasty (THA) does occur, yet questions remain including the overall frequency of this finding, demographic and prosthesis-related factors, and the association of noise generation with patient-reported outcomes. QUESTIONS/PURPOSES: The purposes of this study were (1) to determine the frequency with which patients report noise coming from the hip after THA; (2) to identify patient and prosthesis-related factors associated with noise generation; and (3) to ascertain if noise generation is associated with pain or functional impairment after THA...
October 2016: Clinical Orthopaedics and related Research
Fernando M Judas, Joana Fonseca Ferreira, Rui Freitas Dias, Francisco M Lucas
INTRODUCTION: Lord total hip prosthesis was discontinued due to high revision rates of the smooth threaded acetabular component and negative effects of stress shielding in the proximal femur. PRESENTATION OF CASE: We report the outcome of a Lord cementless femoral stem, in a 55-year-old woman. In 1984, the patient underwent a Lord total hip arthroplasty for the treatment of advanced dysplastic osteoarthritis of the left hip. After 12 years, the cementless acetabular component of the prosthesis had been revised due to aseptic loosening...
2016: International Journal of Surgery Case Reports
Mustafa Celiktas, Emre Togrul, Ozkan Kose
BACKGROUND: The treatment of unstable intertrochanteric fractures in elderly is still controversial. The purpose of this study is to present treatment strategies for unstable intertrochanteric fractures with hemiarthroplasty using standard uncemented collared femoral stems and at the same time preserving the fractured calcar fragment. METHODS: Fifty-four patients aged 75 years or older with unstable intertrochanteric fractures were included in this prospective cohort study...
December 2015: Clinics in Orthopedic Surgery
Jinpeng He, Yun Hao, Xiaolin Wang, Jingfan Shao, Xiaojin Yang, Fengjing Guo, Jiexiong Feng
OBJECTIVE: To investigate the accuracy and value of digital planning with bone parameters in determining the appropriate prosthesis for total hip arthroplasty (THA). METHODS: The preoperative radiographs was taken in 13 cases scheduled for THA between September 2012 and June 2013; the bone parameters were measured by digital template, and the prosthesis was selected and preoperative plan was made. There were 4 males and 9 females with an average age of 54.08 years (range, 41-79 years), including 8 left hips and 5 right hips...
June 2015: Chinese Journal of Reparative and Reconstructive Surgery
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